System-level interventions that link pain assessments to intervention measures are likely to be powerful tools for addressing pain in nursing home residents

System-level interventions that link pain assessments to intervention measures are likely to be powerful tools for addressing pain in nursing home residents, according to a study published online in Pain Management Nursing.

Researchers led by Clint Douglas, RN, PhD, from the Wesley Mission Brisbane Pain Research Interest Group in Queensland, Australia, implemented a pain identification tool along with pain recognition training for nurses and nonprofessional staff at 5 eldercare facilities. Outcomes were compared with that of usual training and standardized care at 4 other facilities operated by the same organization.

Results showed that the 3-month intervention was associated with significant improvement in routine pain assessment and use of nonpharmacologic pain interventions.

However, the effect was confounded by unexpected changes in the control group, and attenuated by relatively high baseline knowledge, skills, and confidence for pain assessment in both groups, the authors suggest.

"I was really surprised, and I agree with [the researchers] that probably part of the reason they didn't get the positive outcomes they anticipated is that the facilities have unusually high knowledge and perceived confidence," Keela Herr, RN, PhD, associate dean for faculty in the College of Nursing at the University of Iowa, and specialist in geriatric pain research and education, told Clinical Pain Advisor.

"When you start out with those high levels, it is hard to show significant change, and those scores were much higher than what you typically see in this kind of study and in nursing homes in particular. So obviously this organization is already doing something right in their approach to pain care," Dr Herr pointed out.

"We found the introduction of pain identification resources with implementation strategies to support frontline staff over a 3-month period was partially effective in improving staff and resident outcomes. Nonetheless, our findings confirm the need for change and importance of translational pain research in residential aged care facilities," the authors write.